tbuckley/cabot-search huggingface dataset:
Top Surgery and Chest Dysphoria Among Transmasculine and Nonbinary Adolescents and Young Adults
Authors: Mona Ascha, Daniel C. Sasson, Rachita Sood, Jeremy W. Cornelius, Jacob M. Schauer, Adariane Runge, Abigail L. Muldoon, Noopur Gangopadhyay, Lisa Simons, Diane Chen, Julia F. Corcoran, Sumanas W. Jordan
Journal: JAMA Pediatrics (2022)

Transgender and nonbinary (TGNB) adolescents and young adults (AYA) designated female at birth (DFAB) experience chest dysphoria, which is associated with depression and anxiety. Top surgery may be performed to treat chest dysphoria.To determine whether top surgery improves chest dysphoria, gender congruence, and body image in TGNB DFAB AYA.This is a nonrandomized prospective cohort study of patients who underwent top surgery between December 2019 and April 2021 and a matched control group who did not receive surgery. Patients completed outcomes measures preoperatively and 3 months postoperatively. This study took place across 3 institutions in a single, large metropolitan city. Patients aged 13 to 24 years who presented for gender-affirming top surgery were recruited into the treatment arm. Patients in the treatment arm were matched with individuals in the control arm based on age and duration of testosterone therapy.Patients in the surgical cohort underwent gender-affirming mastectomy; surgical technique was at the discretion of the surgeon.Patient-reported outcomes were collected at enrollment and 3 months postoperatively or 3 months postbaseline for the control cohort. The primary outcome was the Chest Dysphoria Measure (CDM). Secondary outcomes included the Transgender Congruence Scale (TCS) and Body Image Scale (BIS). Baseline demographic and surgical variables were collected, and descriptive statistics were calculated. Inverse probability of treatment weighting (IPTW) was used to estimate the association of top surgery with outcomes. Probability of treatment was estimated using gradient-boosted machines with the following covariates: baseline outcome score, age, gender identity, race, ethnicity, insurance type, body mass index, testosterone use duration, chest binding, and parental support.Overall, 81 patients were enrolled (mean [SD] age, 18.6 [2.7] years); 11 were lost to follow-up. Thirty-six surgical patients and 34 matched control patients completed the outcomes measures. Weighted absolute standardized mean differences were acceptable between groups with respect to body mass index, but were not comparable with respect to the remaining demographic variables baseline outcome measures. Surgical complications were minimal. IPTW analyses suggest an association between surgery and substantial improvements in CDM (-25.58 points; 95% CI, -29.18 to -21.98), TCS (7.78 points; 95% CI, 6.06-9.50), and BIS (-7.20 points; 95% CI, -11.68 to -2.72) scores.Top surgery in TGNB DFAB AYA is associated with low complication rates. Top surgery is associated with improved chest dysphoria, gender congruence, and body image satisfaction in this age group.
Prevalence and Sources of Duplicate Information in the Electronic Medical Record
Authors: Jackson Steinkamp, Jacob J. Kantrowitz, Subha Airan-Javia
Journal: JAMA Network Open (2022)

Duplicated text is a well-documented hazard in electronic medical records (EMRs), leading to wasted clinician time, medical error, and burnout. This study hypothesizes that text duplication is prevalent and increases with time and EMR size and that duplicate information is shared across authors.To examine the prevalence and scope of duplication behavior in clinical notes from a large academic health system and the factors associated with duplication.This retrospective, cross-sectional analysis of note length and content duplication rates used a set of 10 adjacent word tokens (ie, a 10-gram) sliding-window approach to identify spans of text duplicated exactly from earlier notes in a patient's record for all inpatient and outpatient notes written within the University of Pennsylvania Health System from January 1, 2015, through December 31, 2020. Text duplicated from a different author vs text duplicated from the same author was quantified. Furthermore, novel text and duplicated text per author for various note types and author types, as well as per patient record by number of notes in the record, were quantified. Information scatter, another documentation hazard, was defined as the inverse of novel text per note, and the association between information duplication and information scatter was graphed. Data analysis was performed from January to March 2022.Total, novel, and duplicate text by note type and note author were determined, as were the mean intra-author and inter-author duplication per note by type and author.There were a total of 104 456 653 notes for 1 960 689 unique patients consisting of 32 991 489 889 words; 50.1% of the total text in the record (16 523 851 210 words) was duplicated from prior text written about the same patient. The duplication fraction increased year-over-year, from 33.0% for notes written in 2015 to 54.2% for notes written in 2020. Of the text duplicated, 54.1% came from text written by the same author, whereas 45.9% was duplicated from a different author. Records with more notes had more total duplicate text, approaching 60%. Note types with high information scatter tended to have low information overload, and vice versa, suggesting a trade-off between these 2 hazards under the current documentation paradigm.Duplicate text casts doubt on the veracity of all information in the medical record, making it difficult to find and verify information in day-to-day clinical work. The findings of this cross-sectional study suggest that text duplication is a systemic hazard, requiring systemic interventions to fix, and simple solutions such as banning copy-paste may have unintended consequences, such as worsening information scatter. The note paradigm should be further examined as a major cause of duplication and scatter, and alternative paradigms should be evaluated.
Top Surgery in Adolescents and Young Adults—Effective and Medically Necessary
Authors: Kishan M. Thadikonda, Katherine M. Gast
Journal: JAMA Pediatrics (2022)

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Association of Primary and Booster Vaccination and Prior Infection With SARS-CoV-2 Infection and Severe COVID-19 Outcomes
Authors: Dan-Yu Lin, Yu Gu, Yangjianchen Xu, Bradford Wheeler, Hayley Young, Shadia Khan Sunny, Zack Moore, Donglin Zeng
Journal: JAMA (2022)

Importance Data about the association of COVID-19 vaccination and prior SARS-CoV-2 infection with risk of SARS-CoV-2 infection and severe COVID-19 outcomes may guide prevention strategies. Objective To estimate the time-varying association of primary and booster COVID-19 vaccination and prior SARS-CoV-2 infection with subsequent SARS-CoV-2 infection, hospitalization, and death. Design, Setting, and Participants Cohort study of 10.6 million residents in North Carolina from March 2, 2020, through June 3, 2022. Exposures COVID-19 primary vaccine series and boosters and prior SARS-CoV-2 infection. Main Outcomes and Measures Rate ratio (RR) of SARS-CoV-2 infection and hazard ratio (HR) of COVID-19–related hospitalization and death. Results The median age among the 10.6 million participants was 39 years; 51.3% were female, 71.5% were White, and 9.9% were Hispanic. As of June 3, 2022, 67% of participants had been vaccinated. There were 2 771 364 SARS-CoV-2 infections, with a hospitalization rate of 6.3% and mortality rate of 1.4%. The adjusted RR of the primary vaccine series compared with being unvaccinated against infection became 0.53 (95% CI, 0.52-0.53) for BNT162b2, 0.52 (95% CI, 0.51-0.53) for mRNA-1273, and 0.51 (95% CI, 0.50-0.53) for Ad26.COV2.S 10 months after the first dose, but the adjusted HR for hospitalization remained at 0.29 (95% CI, 0.24-0.35) for BNT162b2, 0.27 (95% CI, 0.23-0.32) for mRNA-1273, and 0.35 (95% CI, 0.29-0.42) for Ad26.COV2.S and the adjusted HR of death remained at 0.23 (95% CI, 0.17-0.29) for BNT162b2, 0.15 (95% CI, 0.11-0.20) for mRNA-1273, and 0.24 (95% CI, 0.19-0.31) for Ad26.COV2.S. For the BNT162b2 primary series, boosting in December 2021 with BNT162b2 had the adjusted RR relative to primary series of 0.39 (95% CI, 0.38-0.40) and boosting with mRNA-1273 had the adjusted RR of 0.32 (95% CI, 0.30-0.34) against infection after 1 month and boosting with BNT162b2 had the adjusted RR of 0.84 (95% CI, 0.82-0.86) and boosting with mRNA-1273 had the adjusted RR of 0.60 (95% CI, 0.57-0.62) after 3 months. Among all participants, the adjusted RR of Omicron infection compared with no prior infection was estimated at 0.23 (95% CI, 0.22-0.24) against infection, and the adjusted HRs were 0.10 (95% CI, 0.07-0.14) against hospitalization and 0.11 (95% CI, 0.08-0.15) against death after 4 months. Conclusions and Relevance Receipt of primary COVID-19 vaccine series compared with being unvaccinated, receipt of boosters compared with primary vaccination, and prior infection compared with no prior infection were all significantly associated with lower risk of SARS-CoV-2 infection (including Omicron) and resulting hospitalization and death. The associated protection waned over time, especially against infection.
Cancer Risk in Children of Mothers With Epilepsy and High-Dose Folic Acid Use During Pregnancy
Authors: Håkon Magne Vegrim, Julie Werenberg Dreier, Silje Alvestad, Nils Erik Gilhus, Mika Gissler, Jannicke Igland, Maarit K. Leinonen, Torbjörn Tomson, Yuelian Sun, Helga Zoega, Jakob Christensen, Marte-Helene Bjørk
Journal: JAMA Neurology (2022)

Women with epilepsy are recommended high doses of folic acid before and during pregnancy owing to risk of congenital anomalies associated with antiseizure medications. Whether prenatal exposure to high-dose folic acid is associated with increases in the risk of childhood cancer is unknown.To assess whether high-dose folic acid supplementation in mothers with epilepsy is associated with childhood cancer.Observational cohort study conducted with nationwide registers in Denmark, Norway, and Sweden from 1997 to 2017. Analyses were performed during January 10, 2022, to January 31, 2022. Mother-child pairs were identified in medical birth registers and linked with information from patient, prescription, and cancer registers, as well as with sociodemographic information from statistical agencies, and were categorized by maternal diagnosis of epilepsy. The study population consisted of 3 379 171 children after exclusion of 126 711 children because of stillbirth or missing or erroneous values on important covariates.Maternal prescription fills for high-dose folic acid tablets (≥1 mg daily) between 90 days before pregnancy start and birth.First onset of childhood cancer at younger than 20 years. Cox proportional hazards models were used to calculate adjusted hazard ratios with corresponding 95% CIs, adjusted for potential confounders. Cumulative incidence at aged 20 years was used as a measure of absolute risk.The median age at the end of follow-up in the study population of 3 379 171 children was 7.3 years (IQR, 3.5-10.9 years). Among the 27 784 children (51.4% male) born to mothers with epilepsy, 5934 (21.4%) were exposed to high-dose folic acid (mean dose, 4.3 mg), with 18 exposed cancer cases compared with 29 unexposed, producing an adjusted hazard ratio of 2.7 (95% CI, 1.2-6.3), absolute risk if exposed of 1.4% (95% CI, 0.5%-3.6%), and absolute risk if unexposed of 0.6% (95% CI, 0.3%-1.1%). In children of mothers without epilepsy, 46 646 (1.4%) were exposed to high-dose folic acid (mean dose, 2.9 mg), with 69 exposed and 4927 unexposed cancer cases and an adjusted hazard ratio of 1.1 (95% CI, 0.9-1.4; absolute risk, 0.4% [95% CI, 0.3%-0.5%]). There was no association between children born to mothers with epilepsy who were prenatally exposed to antiseizure medications, but not high-dose folic acid, and an increased risk of cancer (absolute risk, 0.6%; 95% CI, 0.2%-1.3%).Prenatal exposure to high-dose folic acid was associated with increased risk of cancer in children of mothers with epilepsy.
Single-cell genome sequencing of human neurons identifies somatic point mutation and indel enrichment in regulatory elements
Authors: Lovelace J. Luquette, Michael B. Miller, Zinan Zhou, Craig L. Bohrson, Yifan Zhao, Hu Jin, Doga Gulhan, Javier Ganz, Sara Bizzotto, Samantha Kirkham, Tino Hochepied, Claude Libert, Alon Galor, Junho Kim, Michael A. Lodato, Juan I. Garaycoechea, Charles Gawad, Jay West, Christopher A. Walsh, Peter J. Park
Journal: Nature Genetics (2022)
Association of Research and Development Investments With Treatment Costs for New Drugs Approved From 2009 to 2018
Authors: Olivier J. Wouters, Lucas A. Berenbrok, Meiqi He, Yihan Li, Inmaculada Hernandez
Journal: JAMA Network Open (2022)

Drug companies frequently claim that high prices are needed to recoup spending on research and development. If high research and development costs justified high drug prices, then an association between these 2 measures would be expected.To examine the association between treatment costs and research and development investments for new therapeutic agents approved by the US Food and Drug Administration (FDA) from 2009 to 2018.This cross-sectional study analyzed 60 drugs approved by the FDA between January 1, 2009, and December 31, 2018, for which data on research and development investments and list or net prices were available. Data sources included the FDA and SSR Health databases.The primary independent variable was estimated research and development investment. The outcome was standardized treatment costs (ie, annual treatment costs for both chronic and cycle drugs, and treatment costs for the maximum length of treatment recommended for acute drugs). Standardized treatment costs were estimated separately using list and net prices obtained from SSR Health at the time of launch and in 2021. To test the association between research and development investments and treatment costs, correlation coefficients were estimated and linear regression models were fitted that controlled for other factors that were associated with treatment costs, such as orphan status. Two models were used: a fully adjusted model that was adjusted for all variables in the data set associated with treatment costs and a parsimonious model in which highly correlated variables were excluded.No correlation was observed between estimated research and development investments and log-adjusted treatment costs based on list prices at launch (R = -0.02 and R2 = 0.0005; P = .87) or net prices 1 year after launch (R = 0.08 and R2 = 0.007; P = .73). This result held when 2021 prices were used to estimate treatment costs. The linear regression models showed no association between estimated research and development investments and log-adjusted treatment costs at launch (β = 0.002 [95% CI, -0.02 to 0.02; P = .84] in the fully adjusted model; β = 0.01 [95% CI, -0.01 to 0.03; P = .46] in the parsimonious model) or from 2021 (β = -0.01 [95% CI, -0.03 to 0.01; P = .30] in the fully adjusted model; β = -0.004 [95% CI, -0.02 to 0.02; P = .66] in the parsimonious model).Results of this study indicated that research and development investments did not explain the variation in list prices for the 60 drugs in this sample. Drug companies should make further data available to support their claims that high drug prices are needed to recover research and development investments, if they are to continue to use this argument to justify high prices.
Incidence of Severe COVID-19 Illness Following Vaccination and Booster With BNT162b2, mRNA-1273, and Ad26.COV2.S Vaccines
Authors: J. Daniel Kelly, Samuel Leonard, Katherine J. Hoggatt, W. John Boscardin, Emily N. Lum, Tristan A. Moss-Vazquez, Raul Andino, Joseph K. Wong, Amy Byers, Dawn M. Bravata, Phyllis C. Tien, Salomeh Keyhani
Journal: JAMA (2022)

Evidence describing the incidence of severe COVID-19 illness following vaccination and booster with BNT162b2, mRNA-1273, and Ad26.COV2.S vaccines is needed, particularly for high-risk populations.
Effect of Text Messaging Parents of School-Aged Children on Outdoor Time to Control Myopia
Authors: Shi-Ming Li, An-Ran Ran, Meng-Tian Kang, Xiaoyuan Yang, Ming-Yang Ren, Shi-Fei Wei, Jia-He Gan, Lei Li, Xi He, He Li, Luo-Ru Liu, Yipeng Wang, Si-Yan Zhan, David A. Atchison, Ian Morgan, Ningli Wang, Paul Mitchell, Yazhou Ji, Weixin He, Hailin Meng, Yongfang Tu, Hongyuan Wang, Jing Fu, Siyuan Li, Zhou Yang, Jiyuan Guo, Shiqiang Zhao, Bidan Zhu, Yunyun Sun, Bo Meng, Yizao Zhang, Jinling Li
Journal: JAMA Pediatrics (2022)

Myopia in school-aged children is a public health issue worldwide; consequently, effective interventions to prevent onset and progression are required.To investigate whether SMS text messages to parents increase light exposure and time outdoors in school-aged children and provide effective myopia control.This randomized clinical trial was conducted in China from May 2017 to May 2018, with participants observed for 3 years. Of 528 965 primary school-aged children from Anyang, 3113 were randomly selected. Of these, 268 grade 2 schoolchildren were selected and randomly assigned to SMS and control groups. Data were analyzed from June to December 2021.Parents of children in the SMS group were sent text messages twice daily for 1 year to take their children outdoors. All children wore portable light meters to record light exposure on 3 randomly selected days (2 weekdays and 1 weekend day) before and after the intervention.The co-primary outcomes were change in axial length (axial elongation) and change in spherical equivalent refraction (myopic shift) from baseline as measured at the end of the intervention and 3 years later. A secondary outcome was myopia prevalence.Of 268 grade 2 schoolchildren, 121 (45.1%) were girls, and the mean (SD) age was 8.4 (0.3) years. Compared with the control group, the SMS intervention group demonstrated greater light exposure and higher time outdoors during weekends, and the intervention had significant effect on axial elongation (coefficient, 0.09; 95% CI, 0.02-0.17; P = .01). Axial elongation was lower in the SMS group than in the control group during the intervention (0.27 mm [95% CI, 0.24-0.30] vs 0.31 mm [95% CI, 0.29-0.34]; P = .03) and at year 2 (0.39 mm [95% CI, 0.35-0.42] vs 0.46 mm [95% CI, 0.42-0.50]; P = .009) and year 3 (0.30 mm [95% CI, 0.27-0.33] vs 0.35 mm [95% CI, 0.33-0.37]; P = .005) after the intervention. Myopic shift was lower in the SMS group than in the control group at year 2 (-0.69 diopters [D] [95% CI, -0.78 to -0.60] vs -0.82 D [95% CI, -0.91 to -0.73]; P = .04) and year 3 (-0.47 D [95% CI, -0.54 to -0.39] vs -0.60 D [95% CI, -0.67 to -0.53]; P = .01) after the intervention, as was myopia prevalence (year 2: 38.3% [51 of 133] vs 51.1% [68 of 133]; year 3: 46.6% [62 of 133] vs 65.4% [87 of 133]).In this randomized clinical trial, SMS text messages to parents resulted in lower axial elongation and myopia progression in schoolchildren over 3 years, possibly through increased outdoor time and light exposure, showing promise for reducing myopia prevalence.Chinese Clinical Trial Registry Identifier: ChiCTR-IOC-17010525.
A soft robotic sleeve mimicking the haemodynamics and biomechanics of left ventricular pressure overload and aortic stenosis
Authors: Luca Rosalia, Caglar Ozturk, Jaume Coll-Font, Yiling Fan, Yasufumi Nagata, Manisha Singh, Debkalpa Goswami, Adam Mauskapf, Shi Chen, Robert A. Eder, Efrat M. Goffer, Jo H. Kim, Salva Yurista, Benjamin P. Bonner, Anna N. Foster, Robert A. Levine, Elazer R. Edelman, Marcello Panagia, Jose L. Guerrero, Ellen T. Roche, Christopher T. Nguyen
Journal: Nature Biomedical Engineering (2022)
Tackling bias in AI health datasets through the STANDING Together initiative
Authors: Shaswath Ganapathi, Jo Palmer, Joseph E. Alderman, Melanie Calvert, Cyrus Espinoza, Jacqui Gath, Marzyeh Ghassemi, Katherine Heller, Francis Mckay, Alan Karthikesalingam, Stephanie Kuku, Maxine Mackintosh, Sinduja Manohar, Bilal A. Mateen, Rubeta Matin, Melissa McCradden, Lauren Oakden-Rayner, Johan Ordish, Russell Pearson, Stephen R. Pfohl, Negar Rostamzadeh, Elizabeth Sapey, Neil Sebire, Viknesh Sounderajah, Charlotte Summers, Darren Treanor, Alastair K. Denniston, Xiaoxuan Liu
Journal: Nature Medicine (2022)
Increased glucose metabolism in TAMs fuels O-GlcNAcylation of lysosomal Cathepsin B to promote cancer metastasis and chemoresistance
Authors: Qingzhu Shi, Qicong Shen, Yanfang Liu, Yang Shi, Wenwen Huang, Xi Wang, Zhiqing Li, Yangyang Chai, Hao Wang, Xiangjia Hu, Nan Li, Qian Zhang, Xuetao Cao
Journal: Cancer Cell (2022)
Worksite-based intensive lifestyle therapy has profound cardiometabolic benefits in people with obesity and type 2 diabetes
Authors: Mihoko Yoshino, Jun Yoshino, Gordon I. Smith, Richard I. Stein, Adam J. Bittel, Daniel C. Bittel, Dominic N. Reeds, David R. Sinacore, W. Todd Cade, Bruce W. Patterson, Kevin Cho, Gary J. Patti, Bettina Mittendorfer, Samuel Klein
Journal: Cell Metabolism (2022)
Optic nerve sheath diameter on computed tomography is correlated with simultaneously measured intracranial pressure in patients with severe traumatic brain injury
Authors: Mypinder S. Sekhon, Donald E. Griesdale, Chiara Robba, Nick McGlashan, Edward Needham, Katherine Walland, Alyssa C. Shook, Peter Smielewski, Marek Czosnyka, Arun K. Gupta, David K. Menon
Journal: Intensive Care Medicine (2014)
Maternally transferred mAbs protect neonatal mice from HSV-induced mortality and morbidity
Authors: Iara M. Backes, Brook K. Byrd, Matthew D. Slein, Chaya D. Patel, Sean A. Taylor, Callaghan R. Garland, Scott W. MacDonald, Alejandro B. Balazs, Scott C. Davis, Margaret E. Ackerman, David A. Leib
Journal: The Journal of Experimental Medicine (2022)

Neonatal herpes simplex virus (nHSV) infections often result in significant mortality and neurological morbidity despite antiviral drug therapy. Maternally transferred herpes simplex virus (HSV)-specific antibodies reduce the risk of clinically overt nHSV, but this observation has not been translationally applied. Using a neonatal mouse model, we tested the hypothesis that passive transfer of HSV-specific human mAbs can prevent mortality and morbidity associated with nHSV. The mAbs were expressed in vivo via vectored immunoprophylaxis or recombinantly. Through these maternally derived routes or through direct administration to pups, diverse mAbs to HSV glycoprotein D protected against neonatal HSV-1 and HSV-2 infection. Using in vivo bioluminescent imaging, both pre- and post-exposure mAb treatment significantly reduced viral load in mouse pups. Together these studies support the notion that HSV-specific mAb-based therapies could prevent or improve HSV infection outcomes in neonates.